Why a normal diabetes test can be wrong
Normal glycosylated hemoglobin masking glucose dysregulation in a patient with pancreatic and hematologic disease
Not medical advice. For informational purposes only. Always consult a healthcare professional. Terms
Sometimes, a blood test for diabetes called HbA1c can look normal even when blood sugar is too high. This happened to a woman with other health problems like pancreatic cysts and a blood condition linked to inflammation.
Surprising Findings
Normal HbA1c despite severe hyperglycemia confirmed by CGM and OGTT
HbA1c is considered the gold standard for long-term glucose control. Most doctors would rule out diabetes with a 4.7% result—but here, it completely missed dangerous highs over 350 mg/dL.
Practical Takeaways
If you have unexplained fatigue, brain fog, or blood sugar symptoms but a normal A1c, ask your doctor about a CGM or OGTT.
Not medical advice. For informational purposes only. Always consult a healthcare professional. Terms
Sometimes, a blood test for diabetes called HbA1c can look normal even when blood sugar is too high. This happened to a woman with other health problems like pancreatic cysts and a blood condition linked to inflammation.
Surprising Findings
Normal HbA1c despite severe hyperglycemia confirmed by CGM and OGTT
HbA1c is considered the gold standard for long-term glucose control. Most doctors would rule out diabetes with a 4.7% result—but here, it completely missed dangerous highs over 350 mg/dL.
Practical Takeaways
If you have unexplained fatigue, brain fog, or blood sugar symptoms but a normal A1c, ask your doctor about a CGM or OGTT.
Publication
Journal
JCEM Case Reports
Year
2026
Authors
Jean Carlos Ramos Cardona, Jacqueline Rodriguez Gilmore, Tathana Rivera Hernandez, Suzanne Quinn Martinez
Related Content
Claims (5)
Even if someone’s blood sugar test (HbA1c) looks normal, doctors might still find high blood sugar using other tests like CGM or OGTT—especially if they have certain health issues like inflammation or pancreas problems.
Sometimes, changes in blood cells that happen as people age might mess with blood sugar readings, even if their blood is otherwise healthy.
Some people with chronic inflammation and certain blood and pancreas conditions might have normal blood sugar readings on standard A1c tests, even though their actual blood sugar is high — because inflammation makes red blood cells die faster, so there's less time for sugar to stick to them.
Some types of cysts or tumors in the pancreas might mess with blood sugar control, even if a person doesn’t have diabetes or obvious pancreas problems.
Type 2 diabetes means your blood sugar stays too high over time, and doctors check this with two tests: one after you've fasted and another called HbA1c that shows how much sugar has been sticking to your red blood cells over the past few months.